Statement of Concern from David A. Wiss, MS, RDN, CPT

“As a Registered Dietitian Nutritionist (RDN/RD) and active member of the Academy of Nutrition and Dietetics (The Academy), I feel a moral obligation to express concern about my professional organization, particularly in light of the current public health crisis with obesity and food-related problems. My ethical objections stem from the paradoxical relationship between The Academy and the food industry, also known as Big Food. My views on this matter strongly support the mission of Dietitians for Professional Integrity (DFPI), which is proactive in seeking change and willing to challenge suspicious partnerships within the food industry.

This year’s annual Food and Nutrition Conference and Expo (FNCE) was held October 19-22, 2013, in Houston, Texas, and was attended by 8,000 dietitians, nutrition science researchers, policy makers, healthcare providers, and industry leaders. There were over 350 exhibitors with a display at the Expo, and more than 100 educational sessions that provide Continuing Professional Education (CPE) credits for RDNs and Diet Techs Registered (DTR). The Coca-Cola Company was a “Partner” for the event with their logo appearing throughout the conference, including the first page of the program book and the event tote bag. PepsiCo (a Premier Sponsor) and McDonald’s joined other food industry giants on the Expo floor with massive display booths, many staffed with dietitians. While these are just three of the many companies present at FNCE, overall it appeared to be a food industry event rather than a nutrition conference.

From my perspective, the educational message conveyed was inconsistent with my experience working with patients struggling with obesity, binge eating, and addiction to various substances including food. What is particularly difficult to understand is how and why the food industry sponsors were able to host educational sessions and essentially provide CPEs to RDNs/DTRs. The companies that manufacture nutrient-poor foods commonly associated with overeating provided free items, sponsored meals, and provided the latest “evidence” regarding their product’s benefits. Food industry giants clearly have an incentive to influence dietitians and have available resources to do so.

One of the booths I visited at the Expo was The Sugar Association, offering handouts with statements like “studies show that sugar is uniquely satiating” and “the scientific evidence is clear, dietary sugars per-se pose no direct negative health impact.” One brochure stated that sugar is “all natural” and has only 15 calories per teaspoon, described as the amount of energy burned during 13 minutes of sleep.

A panel on weight management did not address any of the issues created by processed foods, added sugars, or the potential for food addiction in certain populations. The message of the educational session endorsed the “calories in calories out” model of weight management, ignoring the value of micronutrients, and the behavioral impact of brain chemistry and hormones. The message that “all foods fit” and everything should be consumed in moderation is consistent with and supports the agenda of Big Food.

Unfortunately, as the obesity epidemic continues to worsen, patients continue to experience dysfunctional relationships to highly processed/sweetened foods and beverages, and many struggle with “moderation.” While “all foods fit” certainly has merit and is a realistic approach to food consumption for many people, I must ask: is Coke even a food? I say it is not!

Since 2007 there has been considerable research on the topic of food addiction. What is known is that the same (dopaminergic) pathways involved in drug addiction are involved in food consumption. Obese subjects and drug-addicted subjects display similar brain imaging characteristics related to reward-response. Unprocessed and unsweetened foods do not trigger the brain like highly palatable foods, notorious for containing added sugars, salts, and fats, as well as refined grains and caffeine. As a practicing dietitian I frequently encounter the classic feature of addiction: continued use of a substance (food) despite negative consequences. While the research on the addictive nature of processed food/beverages continues to strengthen, The Academy does not support the concept of food addiction and none of the sessions at FNCE addressed this important topic. Could a podium presentation objectively discuss food addiction at an event sponsored by McDonald’s and Coca-Cola?

Not only does industry-favored science appear to be promoted, anti-industry science appears to be censored. Furthermore, photos at the exhibit were banned this year, and Coca-Cola employees were actively enforcing this rule. A security guard stopped me from taking a picture on the Expo floor. What is The Academy hiding? Why is my parent organization censoring me? I pay dues to be a member and I demand answers.

To make matters worse, there were plans for The Academy to host a point-counterpoint discussion on the topic of private-public collaborations, as requested by DFPI. This group has been recommending greater transparency regarding corporate sponsorship, request for input from RDs on the matter, meaningful sponsorship guidelines, rejection of corporate-sponsored education, and increased leadership on nutrition policy. DFPI was formed in attempt to influence The Academy on these issues. Initially The Academy agreed to host a discussion, but the discussion was cancelled for no apparent reason. Instead, two non-dietitians spoke on topics that did not address the specifics of private-public collaborations within our specific organization. In the fifteen minutes left for questions and answers, inquiries about current affairs were not adequately answered and the moderator ensured that there was no active “discussion” on the requested topic.

As a dietitian with a Master’s degree who closely follows current nutrition research, I have turned away from Academy-endorsed scientific “evidence” including the Evidence Analysis Library (EAL). It is unethical for Big Food to provide education for dietitians, particularly with the implication that if you disagree, then you are disagreeing with “science.” What is apparent to me is that The Academy is in the pocket of Big Food, essentially buying the RD credential to “health-wash” products coming under scrutiny by obesity researchers. By announcing a partnership with The Academy, Coca-Cola and others can appear to be concerned with public health, as the American public suffers and dietitians continue to lose credibility.

I agree with DFPI that the problem at hand is not collaboration with the private sector, but rather who in the private sector we align with. For this reason it is critical to propose regulations and guidelines around partnerships in order to preserve the integrity of the RD credential. I strongly believe that companies aligned with the Academy should support practices for reducing the prevalence of obesity and disordered eating, and protecting global environmental welfare.

By minimizing ties with companies that deceitfully promote health in their public relations campaigns but not in actual practice, consumers are more likely to turn to dietitians to provide reliable evidence-based treatment recommendations. It is of paramount importance that nutrition education for dietitians be unbiased and based on objective evidence performed by independent researchers. I hope that open dialogue between DFPI and The Academy can improve communication and transparency so that sponsorships ultimately strengthen rather than compromise our reputation.”

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